Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT0002581 | FL |
NPI | 1104832989 |
---|---|
Provider Name | Mrs. Joan Ramker |
First Address | Palm Harbor, FL 34683-3454 |
Second Address | Palm Harbor, FL 34683-5235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
880345500 | (05) | FL |